HHS Pathophysiology
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, -High glucose d/t available insulin not being used
-Hormones elevated include: cortisol, glucagon, catecholamines, and
growth hormone
-increased glucogensis; more hepatic glucose production (too much)
-Increased glucose and increased osmolality of ECF draws water out of
cells causing dehydration
-Initial increase in GFR, increased diuresis, which also leads to dehydration
Symptoms/Presentation of HHS
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-Blood sugar > 600
-Poor tissue turgor (r/t dehydration)
-May have N/V but < DKA
-Disorientation
-No abdominal pain
-Leg cramps
-Vision disturbances
-Weakness
-Can have hemipareis
-Lethargy
-Seizures
Symptoms/Presentation of DKA
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, Early:
-polyuria
-polydipsia (thirst)
-Polyphagia
-"Fruity" breath
-N/V
-High blood sugar > 250
Late:
-Abdominal Pain (hallmark)
-Dehydration
-Weakness
-Confusion
-Shock
-Ketones in blood and urine
Give Hypertonic Fluids Post Operative Because. . .
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it helps with excretion and that is why we want patients to use the
bathroom and excrete after surgeries
Quiz Q: During a home visit, the nurse discovers that the client is less verbal, less
active, less responsive to directions, and severely anxious. The nurse interprets these
findings to indicate that the client needs which intervention?
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A sleep aid.
A clinic appointment.
Increased dose of medication.
, >>Hospitalization.
Hypokalemia S/Sx & Causes
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Signs:
-low potassium is seen with alka"LOW"sis
-Assess for weakness, tiredness, cramping
-May have palpitations heart "skipping beats"
-Can cause nausea/vomiting
Can be caused from:
-Seen with / caused by chronic kidney disease
-Associated with diarrhea, excessive laxative use, excessive vomiting
-Caused by diuretics, bariatric surgery, alcoholism
Colloids
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Albumin, blood, plasma, dextran 40
-Increases intravascular space without excess fluid.
-Causes intravascular expansion
"Helpful in*: edema, expansion of intravascular spaces, improving tissue
perfusion, prevention of vasospasm, severe anemia
Caution in: CHF, hypervolemia, hemoconcentration
Give this one a try later!
, -High glucose d/t available insulin not being used
-Hormones elevated include: cortisol, glucagon, catecholamines, and
growth hormone
-increased glucogensis; more hepatic glucose production (too much)
-Increased glucose and increased osmolality of ECF draws water out of
cells causing dehydration
-Initial increase in GFR, increased diuresis, which also leads to dehydration
Symptoms/Presentation of HHS
Give this one a try later!
-Blood sugar > 600
-Poor tissue turgor (r/t dehydration)
-May have N/V but < DKA
-Disorientation
-No abdominal pain
-Leg cramps
-Vision disturbances
-Weakness
-Can have hemipareis
-Lethargy
-Seizures
Symptoms/Presentation of DKA
Give this one a try later!
, Early:
-polyuria
-polydipsia (thirst)
-Polyphagia
-"Fruity" breath
-N/V
-High blood sugar > 250
Late:
-Abdominal Pain (hallmark)
-Dehydration
-Weakness
-Confusion
-Shock
-Ketones in blood and urine
Give Hypertonic Fluids Post Operative Because. . .
Give this one a try later!
it helps with excretion and that is why we want patients to use the
bathroom and excrete after surgeries
Quiz Q: During a home visit, the nurse discovers that the client is less verbal, less
active, less responsive to directions, and severely anxious. The nurse interprets these
findings to indicate that the client needs which intervention?
Give this one a try later!
A sleep aid.
A clinic appointment.
Increased dose of medication.
, >>Hospitalization.
Hypokalemia S/Sx & Causes
Give this one a try later!
Signs:
-low potassium is seen with alka"LOW"sis
-Assess for weakness, tiredness, cramping
-May have palpitations heart "skipping beats"
-Can cause nausea/vomiting
Can be caused from:
-Seen with / caused by chronic kidney disease
-Associated with diarrhea, excessive laxative use, excessive vomiting
-Caused by diuretics, bariatric surgery, alcoholism
Colloids
Give this one a try later!
Albumin, blood, plasma, dextran 40
-Increases intravascular space without excess fluid.
-Causes intravascular expansion
"Helpful in*: edema, expansion of intravascular spaces, improving tissue
perfusion, prevention of vasospasm, severe anemia
Caution in: CHF, hypervolemia, hemoconcentration
